Individual
JOSEPH R. SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
9290 SE SUNNYBROOK BLVD STE 220, CLACKAMAS, OR 97015
(503) 215-2890
Mailing address
PO BOX 3158, PORTLAND, OR 97208-3158
Taxonomy
Speciality
Code
Description
License number
State
2083X0100X
Occupational Medicine Physician
MD00026122
WA
2083X0100X
Occupational Medicine Physician
Primary
MD157761
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500648442
—
OR
Enumeration date
11/29/2006
Last updated
01/28/2021
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